Restraint use in residential programs: why are best practices ignored?

Janice L. LeBel · Kevin Ann Huckshorn · Beth Caldwell

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Healthcare Decision-Making and Restraints Child Welfare and Adoption Restraint-Related Deaths

Abstract

Several states and providers have embarked on initiatives to reduce using restraint and seclusion in residential programs. Restraint and seclusion are associated with harm to youth and staff, significant costs, reduced quality of care, and less engagement of youth and families. Successful reduction/prevention strategies have been identified, implemented, and reported. Both states and residential providers have implemented prevention approaches, made significant changes, reduced restraint/seclusion use, and offered their experience and positive outcomes.

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References

2004Reducing Seclusion & Restraint Use in Mental Health Settings: Core Strategies for Prevention 2005Special Section on Seclusion and Restraint: The Economic Cost of Using Restraint and the Value Added by Restraint Reduction or Elimination 2004Child and Adolescent Inpatient Restraint Reduction: A State Initiative to Promote Strength-Based Care 2005Re-Designing State Mental Health Policy to Prevent the Use of Seclusion and Restraint 2009The Effects of an Action Plan, Staff Training, Management Support and Monitoring on Restraint Use and Costs of Work‐Related Injuries

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2012Restraint and seclusion use in U.S. School settings: Recommendations from allied treatment disciplines.2020Can Children Be Safe if Their Caregivers are Not?: Reflections on the “Promise” Study of Workforce Issues in a Residential Treatment Center for Children 2023Patterns of change in restrictive measures in residential care: Trauma-informed staff training benefits children and youth who need it the Most 2021A Constructive-Developmental Analysis of Satisfaction, Challenge and Coping in Residential Child and Youth Care

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